Thyroid nodule history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The most important aspects in obtaining a history of a patient presenting with thyroid nodule include, looking for the presence of associated symptoms, change in nodule size, previous head or neck radiation exposure, childhood irradiation associated with high risk of malignancy, family history, history of neck pain, sudden increase in the size of a neck lump, and progressive voice change or hoarseness. The symptoms associated to thyroid nodule include, dysphagia or anterior neck discomfort, hoarseness, localized pain in the neck, shortness of breath, and prolonged cough.
History and Symptoms
History
Obtaining a detailed history is one of the important aspects of determining the best approach towards nodule management. It provides insight into possible cause, precipitating factors and associated comorbid conditions. Complete history may also helps in determining the prognosis. Specific histories about associated symptoms and their duration, onset, and progression have to be obtained. Specific areas of focus when obtaining the history, are outlined below:[1][2][3]
- The presence of associated symptoms
- A change in nodule size
- Previous head or neck radiation exposure
- Childhood irradiation associated with high risk of malignancy
- Family history
- History of neck pain
- Sudden increase in the size of a neck lump
- Raise the concern of malignancies and hemorrhagic thyroid cysts
- Progressive voice change or hoarseness
- May be associated with an invasive thyroid carcinoma
Common symptoms [4][5][3][6]
- Dysphagia or anterior neck discomfort
- May indicate a malignant tumor
- Rarely seen in benign tumors
- Choking sensation
- Inability to lie flat
- Hoarseness
- Localized pain in the neck
- Shortness of breath
- Prolonged cough
Less common symptoms
These are mainly due to hot nodules producing hormones:[3][6]
- Palpitation
- Heat intolerance
- Weight loss
- Night sweats
References
- ↑ Popoveniuc G, Jonklaas J (2012). "Thyroid nodules". Med. Clin. North Am. 96 (2): 329–49. doi:10.1016/j.mcna.2012.02.002. PMC 3575959. PMID 22443979.
- ↑ Milas Z, Shin J, Milas M (2011). "New guidelines for the management of thyroid nodules and differentiated thyroid cancer". Minerva Endocrinol. 36 (1): 53–70. PMID 21460787.
- ↑ 3.0 3.1 3.2 Maia FF, Zantut-Wittmann DE (2012). "Thyroid nodule management: clinical, ultrasound and cytopathological parameters for predicting malignancy". Clinics (Sao Paulo). 67 (8): 945–54. PMC 3416902. PMID 22948464.
- ↑ Bomeli SR, LeBeau SO, Ferris RL (2010). "Evaluation of a thyroid nodule". Otolaryngol. Clin. North Am. 43 (2): 229–38, vii. doi:10.1016/j.otc.2010.01.002. PMC 2879398. PMID 20510711.
- ↑ Lawrence W, Kaplan BJ (2002). "Diagnosis and management of patients with thyroid nodules". J Surg Oncol. 80 (3): 157–70. doi:10.1002/jso.10115. PMID 12115799.
- ↑ 6.0 6.1 Nguyen QT, Lee EJ, Huang MG, Park YI, Khullar A, Plodkowski RA (2015). "Diagnosis and treatment of patients with thyroid cancer". Am Health Drug Benefits. 8 (1): 30–40. PMC 4415174. PMID 25964831.